| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE OF NE LLC | 133 FEDERAL STREET BOSTON, MA 02110 | HARVARD PILGRIM HEALTH CARE | $31K | — | $31K | 3.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF MASSACHUSETTS LLC | 980 WASHINGTON ST SUITE 325 DEDHAM, MA 02026 | HARVARD PILGRIM HEALTH CARE | $12K | — | $12K | 1.19% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $4K | — | $4K | 5.04% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | NCB 88 P.O. BOX 1414 MINNEAPOLIS, MN 55480 | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | $81 | — | $81 | 0.09% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 9.72% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 9.73% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $800 | — | $800 | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $635 | — | $635 | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF NEW ENGLAND | 133 FEDERAL STREET BOSTON, MA 02110 | EYEMED VISION CARE | $1K | — | $1K | 9.84% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $88 | $1K | 21.45% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $305 | $244 | $549 | 8.98% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $502 | — | $502 | 10.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $251 | — | $251 | 5.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARVARD PILGRIM HEALTH CARE | 161 | $1.0M |
| Dental | DENTAL SERVICE OF MASSACHUSETTS, INC. D/B/A DELTA DENTAL OF MA | 160 | $85K |
| Vision | EYEMED VISION CARE | 112 | $12K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 143 | $16K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 143 | $26K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 142 | $13K |
| Prescription drug | HARVARD PILGRIM HEALTH CARE | 161 | $1.0M |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 143 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.